![]() In man, diltiazem prevents spontaneous and ergonovine-provoked coronary artery spasm. In the intact animal, prolongation of the AH interval can be seen at higher doses. Like other calcium channel antagonists, diltiazem decreases sinoatrial and atrioventricular conduction in isolated tissues and has a negative inotropic effect in isolated preparations. Hemodynamic and Electrophysiologic Effects The resultant increases in coronary blood flow (epicardial and subendocardial) occur in ischemic and nonischemic models and are accompanied by dose-dependent decreases in systemic blood pressure and decreases in peripheral resistance. Diltiazem produces relaxation of the coronary vascular smooth muscle and dilation of both large and small coronary vascular smooth muscle and dilation of both large and small coronary arteries at drug levels which cause little or no negative inotropic effect. It causes excitation-contraction uncoupling in various myocardial tissues without changes in the configuration of the action potential. In animal models, diltiazem interferes with the slow inward (depolarizing) current in excitable tissue. Spontaneous and ergonovine-induced coronary artery spasms are inhibited by diltiazem. This is accomplished via reductions in heart rate and systemic blood pressure at submaximal and maximal workloads.ĭiltiazem has been shown to be a potent dilator of coronary arteries, both epicardial and subendocardial. Angina: Diltiazem hydrochloride has been shown to produce increases in exercise tolerance, probably due to its ability to reduce myocardial oxygen demand. ![]()
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January 2023
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